Which State Has The Highest Hiv Rate

Which State Has The Highest Hiv Rate – Why HIV/AIDS rates are so high in the ‘public health capital of the world’ and how researchers are trying to turn the tide.

A YOUNG MAN had been receiving AIDS treatment at the Ponce de Leon Center in downtown Atlanta for some time, but suddenly stopped responding. His doctors didn’t know why. Maybe he was depressed. Or suffer from a related infection. Or he just couldn’t ride.

Which State Has The Highest Hiv Rate

Which State Has The Highest Hiv Rate

He eventually managed to return to the center, but by then his AIDS had progressed. He died a few days later.

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There are thousands of men like him in metro Atlanta — young, black, gay or bisexual, and HIV positive. And an alarming number progress to AIDS and die from a disease that has been treated for decades.

The city, home to the Centers for Disease Control and Prevention, one of the largest HIV/AIDS care clinics in the country, and the largest number of funded HIV research programs, is also the epicenter of the US HIV epidemic.

Some zip codes in the Atlanta area have HIV/AIDS rates six to eight times the national average. And by the time patients in Atlanta are diagnosed as HIV-positive, about a quarter have AIDS, meaning they’ve likely lived with the virus for eight to 10 years.

“In downtown Atlanta, there is a general HIV epidemic that mirrors what we’re seeing in some African cities,” said Carlos del Rio, the Hubert Professor at the Rollins School of Public Health and co-director of Emory’s Center for AIDS Research (CFAR). ).

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The reasons are more related to poverty, lack of insurance and stigma than sexual practices. The high rate of HIV/AIDS is largely confined to one specific group – young black men who have sex with men. In fact, AIDS is the leading cause of death among black men ages 35 to 44 in Georgia.

According to studies by Emory’s Rollins School of Public Health, these men do not have more partners and do not engage in more risky sexual behavior than their white counterparts. But they are at a greater disadvantage. They often don’t have insurance. They may not have transportation, so getting to the clinic can be a challenge.

And because of the stigma attached to their sexual orientation, many do not have a support system from family and friends.

Which State Has The Highest Hiv Rate

The result is that the advances in treatment and care that have made HIV a chronic, treatable disease are not available to this group for many.

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“Many headlines talk about the end of AIDS, but there’s a big gap between the glass and the lip when a population is as vulnerable as ours,” said Wendy Armstrong, Emory professor of medicine and director of the Ponce de. The Leon Center, which is part of the Grady Health System and is served by Emory Physicians. “These people are more worried about where they will sleep or where they will eat than about their next HIV treatment.”

“This is not going to be solved by biomedical researchers,” says del Rio, Rollins’ president of global health. “Everyone needs to work together to address all the things that prevent people from getting the diagnosis and treatment they need — lack of insurance, barriers to care, stigma and poverty.” Emory and our partners are making real progress in Atlanta, but we still have a long way to go.

“We’re reaching out to teenagers who are not yet sexually active to try to get them into good habits,” said Patrick Sullivan, a professor of epidemiology at Rollins.

Getting at-risk men to get tested has long been a serious hurdle. Some people just don’t realize that HIV is still such a threat. Others may deny it. And many do not want to be associated with homosexuality or bisexuality, intravenous drug use, or an HIV diagnosis.

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“In many black communities, there’s a huge stigma around being gay, bisexual, or HIV positive,” says Patrick Sullivan, the Charles Howard Candler Professor of Epidemiology at Rollins and director of the school’s Program for Research and Innovation on Sexual Minority Health (PRISM). . . “Part of it is in religion and the concept of masculinity.” We’ve done research on gay stigma, and whites feel less stigma about their sexuality than blacks.

One of Armstrong’s patients moved out of his mother’s house so she wouldn’t find out about his HIV status. – Lives in temporary accommodation, fights against bedbugs and fleas. “She said she was afraid she would be killed if she told her mother about her diagnosis,” he says.

To overcome barriers to screening, Emory and its partners are working to make HIV testing routine and free in a variety of settings. Grady Memorial Hospital has begun “opting out” of HIV testing in its emergency department — check the box if you don’t want to be tested. This test often leads to one or two new diagnoses per day and has since expanded to 13 sites, including primary care and neighborhood clinics.

Which State Has The Highest Hiv Rate

“I’m very passionate about testing patients for HIV,” says Emory emergency physician Bijal Shah. “In 2006, the CDC recommended that all acute care patients between the ages of 13 and 64 be tested for HIV, regardless of their chief complaint or risk profile. I had the opportunity to make routine HIV testing part of our daily routine at Gradio. I am proud to say that we have tested more than 80,000 patients and made more than 500 new HIV diagnoses.

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Dr. Bijal Shah talks to staff at Grady Hospital in Atlanta, where he has expanded HIV testing to patients.

Rollins physician-researcher Ann Spaulding believes prisons are another place where voluntary screenings can have a big impact. Inmates at the Fulton County Jail in Atlanta are overwhelmingly young (average age 33), male (71 percent) and black (87 percent) — close to the high-risk HIV population. Spaulding piloted the use of a voluntary, rapid HIV test as part of the prison’s medical process.

Prisoners who test positive are quickly placed into treatment – ​​often before they leave prison. “It’s not about finding new cases of HIV/AIDS in prisons,” says Spaulding. “It’s about people who were previously infected not leaving prisons without knowing they’re positive and spreading the infection unknowingly.”

Fulton County has since suspended the rapid HIV testing program, despite its success. The move disappointed many and reinforced the belief that Atlanta could do more to expand routine HIV testing.

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“Let’s take a page from other cities’ playbooks,” says Sullivan. “In D.C., you can get tested for HIV at the Department of Motor Vehicles. There are self-testing kiosks in London. New York, San Francisco and Boston are more aggressive in the fight against AIDS than Atlanta.”

Testing is only the first step. Patients must then begin treatment, a process that can be slow and challenging even for those lucky enough to have insurance. Those without insurance rely on the Ryan White HIV/AIDS Program to cover their medical care and support services. Enrollment requires a daunting set of documents, which can prove virtually impossible without transportation or a permanent address.

A few years ago, Fulton County created an AIDS task force that included Emory clinicians as well as other local health professionals, AIDS patients, community advocates and others. The group has set an ambitious goal of treating newly diagnosed patients within 72 hours.

Which State Has The Highest Hiv Rate

Carlos del Rio, Rollins Hubert Chair of Global Health, is co-director of the Emory Center for AIDS Research.

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To that end, Ryan White’s local program has reduced the time frame required to submit eligibility documents.

The medical leadership of the Ponce Center then made efforts to revise the admissions system and revise the medical schedule. The streamlined process worked so well that the facility quickly became overwhelmed.

Wendy Armstrong is an Emory professor of medicine and director of the Ponce de Leon Center, which serves approximately 6,200 people living with HIV/AIDS in the area.

“We have more new patients in six weeks than we typically have in a year,” says Armstrong. “We can cure this epidemic if we can get people to care.”

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Melanie Thompson, an Atlanta physician, Emory School of Medicine graduate and president of the HIV Care Association, says making sure patients stay on their medications can be a challenge in itself.

He tells of one of his patients who did manual labor without health benefits, slept on a friend’s couch and relied on others to drive him to appointments.

Thompson and his team developed a system to track his medication intake, prompting him to remind him when his medication is due and when he has an appointment.

Which State Has The Highest Hiv Rate

“And that is the reality. In a way, the easy job is done.

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